Psychosocial Correlates and Outcomes of Yoga or Walking Among Older Adults

Few researchers have compared psychological correlates and outcomes of yoga with more traditional forms of exercise. The authors' primary aim was to compare changes in the psychosocial outcomes of mood and state anxiety produced by an acute bout of yoga or walking among older adults. The secondary aim was to compare selected psychosocial correlates of activity. Participants were 51 adults who were 50 years of age or older who walked for exercise or participated in a yoga class. Results revealed that yoga participants had significantly greater levels of depression and perceived barriers to exercise, and lower quality of life than did walkers. With control for these differences, yoga practitioners had improved levels of fatigue pre- to postsession, compared with walkers. With control for differences in demographic variables, these changes were no longer significant. It is possible that yoga practitioners seek out mindful-based exercise to cope with greater levels of depression and lower levels of quality of life.     

The Dynamics of Visual Reweighting in Healthy and Fall-Prone Older Adults

Multisensory reweighting (MSR) is an adaptive process that prioritizes the visual, vestibular, and somatosensory inputs to provide the most reliable information for postural stability when environmental conditions change. This process is thought to degrade with increasing age and to be particularly deficient in fall-prone versus healthy older adults. In the present study, the authors investigate the dynamics of sensory reweighting, which is not well-understood at any age. Postural sway of young, healthy, and fall-prone older adults was measured in response to large changes in the visual motion stimulus amplitude within a trial. Absolute levels of gain, and the rate of adaptive gain change were examined when visual stimulus amplitude changed from high to low and from low to high. Compared with young adults, gains in both older adult groups were higher when the stimulus amplitude was high. Gains in the fall-prone elderly were higher than both other groups when the stimulus amplitude was low. Both older groups demonstrated slowed sensory reweighting over prolonged time periods when the stimulus amplitude was high. The combination of higher vision gains and slower down weighting in older adults suggest deficits that may contribute to postural instability.     

Disposable Time and Disposable Income: Problem Casino Gambling Behavior in Older Adults

Increasing numbers of retirees spend their leisure time in the ever-growing number of gambling casinos in this country. For most older adults, casino gambling is a new form of excitement and entertainment. However, for some retirees, especially those vulnerable to depression from the changes and losses that can occur in aging, casino gambling can become disordered, problematic, and/or an addiction. Although prevalence studies have examined the incidence of problem gambling in other age groups, little attention has been directed to the impact of casino gambling on older adults. The authors discuss problem and pathological gambling in retired older adults, and provide clinical case examples of a growing number of older adults with problem gambling behaviors seen in an outpatient geriatric psychiatry clinic. Finally, they urge that an evaluation of gambling behaviors be a routine portion of geriatric clinical evaluations.     

Practical Memory Concerns of Older Adults

We examine practical memory concerns in a sample of community-dwelling older adults. Participants responded to open-ended questions that were designed to solicit information regarding memory self-efficacy, memory management, memory remediation, and fears about memory aging in adulthood. Results indicated that (a) important dates, such as birthdays and anniversaries, were easily remembered, but names were not; (b) external memory aids were used most frequently; (c) a desire to improve memory for names and certain types of verbal information was expressed; and (d) loss of independence emerged as a fear associated with memory aging. Implications of these findings for the design of strategies to improve everyday memory performance and clinical memory management in older adults are discussed.     

Absence of Ankle Stiffening While Standing in Focus and Cognitive Task Conditions in Older Adults

Abstract

Research suggests that an external focus or cognitive task may improve postural control. Removing attention from movement production may promote automaticity, or the tasks may promote ankle stiffening. To investigate these two theories, twenty older adults stood while performing baseline standing, internal focus, external focus, and two cognitive tasks. Changes in postural control occurred in external focus and cognitive task conditions compared to baseline and internal focus, while no change occurred in cocontraction indices. This suggests that an external focus and cognitive task can improve postural control in older adults. Since no change occurred in cocontraction indices across conditions, this suggests that stiffening cannot explain these changes. Instead, changes could be due to automaticity of sway.     

老年抑郁症的症状、诊断及测量

对老年抑郁症的症状、诊断和测量的探讨有利于寻找更有效的治疗方法。文章在简要讨论老年抑郁症主要症状以及诊断特点的基础上,重点介绍老年抑郁症的测量工具。文章指出,开展老年抑郁症研究的多学科研究,运用认知神经科学方法深入研究老年抑郁症,制订相对独立的老年抑郁症的分类标准,结合老年抑郁症患者身心特点开发更简便可靠的老年抑郁症量表,将有利于老年抑郁症的进一步研究。     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

When Psychologists Work with Older Adults: A Survey of Ethical Beliefs and Practices

Despite the number of publications concerning legal and ethical issues faced by psychologists, and despite the increased interest in addressing specific concerns related to aging, little is known about the actual beliefs and practices of psychologists when they work with older adults. Given the changing demographics in the United States, many mental health professionals will have contact with older adult clients, and the focus of the present study was to examine the extent to which psychologists are prepared to work competently with older adult clients. Survey data were collected from 156 APA Division 12 (Clinical Psychology) and 17 (Counseling Psychology) members regarding the degree to which they engaged in each of 50 behaviors and the degree to which they considered each behavior ethical. Findings are presented in terms of percentages of responses to items on the questionnaire, and ANOVAs were performed on important demographic items to identify statistically significant differences among variables. Coursework in geropsychology or aging, specialization with older adults, and working with a high percentage of older adults were related to higher scores on the Overall Ethical Behavior scale. Females scored higher than males on the Overall Ethical Belief scale.     

Perceptions of Responsibility and Mental Health Help-Seeking Among Psychologically Distressed Older Adults

This study explored the perceptions of responsibility for the cause and the solution of problems and the models of helping (or helping orientations) characterizing a sample of 319 community-dwelling, psychologically distressed older adults. All participants were referred for psychotherapy and had either accepted or rejected their referrals. We investigated whether the models distinguished acceptors and rejecters of psychotherapy referrals and whether they were differentially associated with help-seeking from nontherapist helpers. Results indicated that the preponderance of respondents subscribed to the moral and compensatory models. The compensatory model was associated with rejection of referrals, whereas the moral model was associated with increased help-seeking both from mental health professionals and from other formal and informal helpers. Implications of the findings for promoting older adults' utilization of mental health services are discussed.     

Useful Field of View and Other Neurocognitive Indicators of Crash Risk in Older Adults

Older adults represent a rapidly growing segment of the driving population. Although most older drivers are safe, research has shown that this group has more crashes per mile driven than most other age groups. The purpose of the present investigation was to examine the utility of a set of commonly used neuropsychological/cognitive tests in comparison to a newer measure of visual attention (Useful Field of View; UFOV®) in predicting state-recorded, at-fault crashes over the previous five years in a group of older adult drivers. Participants (N = 239) completed tests of mental status, visual attention, memory, and UFOV®. Results show that among all cognitive tests administered, UFOV® was most strongly related to crash involvement, with high levels of sensitivity (86.3%) and specificity (84.3%) at the standard cutoff score of 40% reduction. Practical implications for the assessment of crash risk are discussed.     

Review of Social Cognition Research on Stereotyping: Application to Psychologists Working with Older Adults

This paper summarizes a number of cognitive processes that contribute to the formation and maintenance of stereotypes. Specific discussion centers on how these may play a role in shaping perceptions of older adults. Suggestions are offered as to how psychologists might combat their tendency to stereotype because older adults have special needs that must be identified to provide accurate case conceptualization and effective psychotherapy from a professional ethics perspective.     

城市中老年人心理健康量表的编制

本研究以来自全国7 个代表性城市的1373 名中老年人为被试,在文献研究、咨询案例分析、专家访谈和讨论、开放式问卷调查的基础上,从实证研究的角度出发,编制了城市中老年人心理健康量表,并对其信度和效度进行了检验。结果表明:该量表具有良好的信度与效度,可以用于对城市中老年人心理健康水平的分析和诊断。     

Traumatic Brain Injury Outcome in Older Adults: A Critical Review of the Literature

This paper is a critical overview of the literature on older adults' outcome after traumatic brain injury (TBI). Eighteen outcome studies were reviewed. Results indicated that older patients demonstrated an increased risk for negative outcome following TBI when compared to younger patients with similar injury severity. Poorer outcome was characterized by higher mortality rates, decreased likelihood of returning to preinjury living arrangement, and declines in cognitive and affective functioning. In the studies reviewed, discharge destination, global outcome scales, and standardized neuropsychological tests were the primary measures of outcome from elderly TBI. Conceptual and methodological difficulties including variability in the definition of and inadequate measures of recovery from elderly TBI, inadequate control groups, and poor follow-up were discussed. Recommendations for future outcome research to increase uniformity in defining recovery in order to enhance comparability between studies and to tailor cognitive rehabilitation to the special needs of the older TBI patient were provided.     

Head and Trunk Control While Walking in Older Adults with Diabetes: Effects of Balance Confidence

Investigations of gait in older adults with diabetes mellitus (DM) have been primarily focused on lower limb biomechanical parameters. Yet, the upper body accounts for two thirds of the body's mass, and head and trunk control are critical for balance. The authors examined head and trunk control during self-selected comfortable, fast, and dual-task walking and the relationship between balance confidence and potential head-trunk stiffening strategies in older adults with DM without diagnosed diabetic peripheral neuropathy (DPN). Twelve older adults with DM without diagnosed DPN (DM group) and 12 without DM (no-DM group) were recruited. Walking speed, peak-to-peak head and trunk roll displacement, head and trunk roll velocity, and head-trunk correlation were measured while walking at a self-selected comfortable or fastest possible speed with or without a secondary cognitive task. The Activities-specific Balance Confidence scale measured balance confidence. Subtle group differences in axial segmental control (lower trunk roll velocity; higher head-trunk correlation) were apparent in older adults with DM even in the absence of DPN. Balance confidence was 19% lower in the DM group than in the no-DM group, and partially explained (34%) the group difference in head-trunk stiffening. These results emphasize the need for proactive monitoring of postural control and balance confidence before the onset of DPN.     

老年人社会适应性与主观幸福感的结构关系

该研究通过编制适应老年人的社会适应性与主观幸福感问卷,探讨了老年人社会适应性与主观幸福感的结构关系。结果表明,问卷具有良好的结构效度和内部一致性信度,人际交往适应性和角色转换适应性对主观幸福感各维度具有显著的预测价值,生活自理适应性对积极情感具有显著预测作用,但预测力不如人际交往适应性和角色转换适应性,而社会整体变化适应性对主观幸福感不存在预测的价值。地区差异对老年人社会适应性和主观幸福感结构预测关系存在显著的调节效应。     

Memory for Actions of an Event: Older and Younger Adults Compared

Previous studies have shown increased false memory effects in older compared to younger adults. To investigate this phenomenon in event memory, in the present study, the authors presented younger and older adults with a robbery. A distinction was made between verbal and visual actions of the event, and recognition and subjective experience of retrieval (remember/know/guess judgments) were analyzed. Although there were no differences in hits, older adults accepted more false information as true and, consequently, showed less accurate recognition than younger adults. Moreover, older adults were more likely than younger adults to accompany these errors with remember judgments. Young adults accepted fewer false verbal actions than visual ones and awarded fewer remember judgments to their false alarms for verbal than for visual actions. Older adults, however, did not show this effect of type of information. These results suggest that aging is a relevant factor in memory for real-life eyewitness situations.     

Development and Validation of a Short Health Behaviors Index for Use with Low Socioeconomic Status (SES) Older Adults

This study reports on the development and validation of a health behavior index in predominantly low socioeconomic status (SES) older adults. In order to develop and validate the index for use in low SES older adults, the 24-item Health and Human Services HealthStyle Self-Test was used for item generation. It was reduced to a relatively brief instrument, the Short HealthStyle (SHS) Index with 13 items that measures four major content areas of lifestyle behaviors among low SES older adults. The SHS Index was administered to a sample of 350 low SES older individuals. Principal component model factor analysis indicated a four-factor structure. Items loading on the first factor appeared to assess fitness and leisure activities, whereas those loading on the second and third factor assessed nutrition practices and stress control, respectively. A fourth factor assessed drinking/eating behaviors. Discriminant validity of the SHS was confirmed using the Instrumental Activities of Daily Living, and other health measures that indicated distinct constructs. Internal consistency for the SHS was .72 using Chronbach's alpha. Overall, the SHS Index displayed good psychometric properties in this sample, suggesting the appropriateness of using it to measure selected health behaviors with low SES older adults.     

Psychopathology Following Interpersonal Violence: A Comparison of Risk Factors in Older and Younger Adults

A randomly selected sample of 549 women age 55 years and older and 2,669 women age 18–34 years was interviewed via telephone to determine prevalences of physical and sexual assault, posttraumatic stress disorder (PTSD) symptomatology, and depression. Prevalences of sexual and physical assaults were lower in older compared to younger women. In addition, given a trauma, prevalences and proportionate risk of posttraumatic psychopathology and depression were also lower for older, relative to younger women. Specifically, multivariate analyses revealed that sexual assault predicted only PTSD avoidance in older adults, but all forms of PTSD symptomatology and depression in younger adult women. Similarly, physical assault predicted only PTSD re-experiencing symptoms in older women, but all forms of PTSD symptoms and depression in younger women. Self-reported health status was not associated with any increased risk of psychopathology, and low income predicted increased avoidance and depression only in younger women.     

Spiritual,Religious, Nonspiritual,and Nonreligious Narratives in Marginalized Older Adults: A Typology of Coping Styles

SUMMARY

Narrative therapy is an important tool in the phenomenological framing of life events with older clients. Seventy-nine older adults who lived independently in four subsidized high-rise housing facilities in Chicago were interviewed in a research project about managing life challenges. Cases represent four types in a spiritual-religious typology: religious and spiritual, religious only, spiritual only, and neither religious nor spiritual (Zinnbauer, 1997). This article explores how older adults managed adversity and maintained a sense of self-efficacy. Findings indicate that older adults use many references to religion and spirituality in their narratives, either embracing these domains or defining themselves in contrast to them. Narrative therapy suggests that the implications of religious and spiritual resources addressed in client stories may reinforce coping capacity and promote aging well.     

The Use of a Personal Trainer to Enhance Participation of Older Adults with Severe Disabilities in a Community Water Exercise Class

Inclusive instruction was provided for three older adults with profound mental retardation in a water exercise class at a local YMCA. The older adults were taught to exercise through the use of systematic prompting. A multiple baseline design across participants with an embedded reversal was used to evaluate the impact of a personal trainer. The three participants performed the exercise, but regressed without the assistance of the trainer, as demonstrated by the reversal. Data collected during peer prompting and maintenance conditions indicated that the participants continued to exercise at levels higher than baseline but lower than with a personal trainer.